NPIMap

Organization Active NPI

Tulla Perez Inc

Doing business as Advanced Dermaesthetics

  • Dermatology Physician
  • New Canaan, CT
National Provider Identifier
1356774897
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
27844 Issued in CT
Legal business name
TULLA PEREZ INC
Doing business as
Advanced Dermaesthetics
Practice address
39 Pine St
New Canaan, CT 06840-5409
Phone
(203) 972-7546
Fax
(203) 972-5937
NPI assigned
Aug 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Maritza Ivonne Perez, MD
Title
President
Phone
(203) 984-3101

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 27844 CT Primary
Health Service Clinic/Center 261QH0100X 27844 CT

Addresses

Primary practice location

39 Pine St
New Canaan, CT 06840-5409

Mailing address

38 Tommys LN
New Canaan, CT 06840-6332
Phone (203) 972-3802

Other names 1

  • Advanced Dermaesthetics Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523404800000",
    "number": "1356774897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 TOMMYS LN",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068406332",
            "telephone_number": "203-972-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 PINE ST",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068405409",
            "telephone_number": "203-972-7546",
            "fax_number": "203-972-5937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULLA PEREZ INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-20",
        "last_updated": "2018-04-11",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "MARITZA",
        "authorized_official_middle_name": "IVONNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-984-3101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CT",
            "license": "27844",
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CT",
            "license": "27844",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dermaesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Canaan, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.